Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2011-00312 | NC |
N | 2080P0207X | Pediatric Hematology-Oncologist | 2011-00312 | NC |
NPI | 1003080078 |
---|---|
Provider Name | Rebecca Jean Chancey |
First Address | Fayetteville, GA 30215-8143 |
Second Address | Houston, TX 77030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2008 |
Last Update Date | 06/08/2014 |